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Abstract
Objective To investigate the effects of single sensory impairment (SSI; visual or auditory) or dual sensory impairment (DSI; visual and auditory) on dementia and longitudinal changes of neuropsychological test scores.
Methods In this nationwide, prospective, community-based elderly cohort study, KLOSCAD (the Korean Longitudinal Study on Cognitive Aging and Dementia), 6,520 elderly individuals (58–101 years) representing the general population were included. We defined visual and auditory sensory impairment via self-report questionnaire: 932 had normal sensory function, 2,957 had an SSI, and 2,631 had a DSI. Demographic and clinical variables including cognitive outcomes were evaluated every 2 years over 6 years. Through logistic regression, Cox regression, and linear mixed model analysis, the relationship between SSI or DSI and dementia prevalence, dementia incidence, and change in neuropsychological scores were evaluated.
Results At baseline, DSI was significantly associated with increased dementia prevalence compared to normal sensory function (odds ratio [OR] 2.17, 95% confidence interval [CI] 1.17–4.02), but SSI was not (OR 1.27, 95% CI 0.66–2.41). During the 6-year follow-up, the incidence of dementia was significantly higher in the DSI group than in the normal sensory function group (hazard ratio 1.9, 95% CI 1.04–3.46) and neuropsychological scores significantly decreased (β −0.87, 95% CI [−1.17 to −0.58]).
Conclusions Our results suggest that coexisting visual and hearing impairments facilitate dementia prevalence, dementia incidence, and cognitive decline, but visual or hearing impairment alone do not. Visual and hearing impairment may lead to dementia or cognitive decline independent of Alzheimer pathology.
Glossary
- AD=
- Alzheimer disease;
- BMI=
- body mass index;
- CERAD TS=
- Consortium to Establish a Registry for Alzheimer's Disease Total Score;
- CERAD-K=
- Korean version of the Consortium to Establish a Registry for Alzheimer's Disease;
- CI=
- confidence interval;
- CIRS=
- Cumulative Illness Rating Scale;
- DSI=
- dual sensory impairment;
- DSM-IV=
- Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition;
- GDS-KR=
- Korean version of the Geriatric Depression Scale;
- HR=
- hazard ratio;
- KLOSCAD=
- Korean Longitudinal Study on Cognitive Aging and Dementia;
- LMM=
- linear mixed-effects model;
- MCI=
- mild cognitive impairment;
- MMSE=
- Mini-Mental State Examination;
- MOS-SSS=
- Medical Outcomes Study Social Support Survey;
- OR=
- odds ratio;
- SSI=
- single sensory impairment
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
↵* These authors contributed equally to this work.
- Received September 28, 2020.
- Accepted in final form February 5, 2021.
- © 2021 American Academy of Neurology
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